CMS Formulary

Displaying 83241-83250 of 1611142 results.
ID: 83241
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83242
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83243
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 208513
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83244
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 404550
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83245
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 150840
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83246
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 208949
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83247
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 202301
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83248
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000491
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83249
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000497
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 83250
Formulary ID: 00021030
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000499
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0